Active NPI
Matt Hare, LMHC
- Mental Health Counselor
- Marion, IN
National Provider Identifier
1962669796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39001366A
- Practice address
- 505 N Wabash Ave
Marion, IN 46952-2608 - Phone
- (765) 662-3971
- Fax
- (765) 668-6718
- NPI assigned
- May 20, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39001366A | IN | Primary |
Addresses
Primary practice location
505 N Wabash Ave
Marion, IN 46952-2608
Mailing address
505 N Wabash Ave
Marion, IN 46952-2608
Phone (765) 662-3971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100123170A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39001366A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1962669796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 N WABASH AVE",
"city": "MARION",
"state": "IN",
"postal_code": "469522608",
"telephone_number": "765-662-3971",
"fax_number": "765-668-6718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 N WABASH AVE",
"city": "MARION",
"state": "IN",
"postal_code": "469522608",
"telephone_number": "765-662-3971",
"fax_number": "765-668-6718"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARE",
"first_name": "MATT",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-20",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39001366A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100123170A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.